Resistance training reduces hemoglobin A1c by 0.62% and systolic blood pressure by 3.91 mmHg in type 2 diabetes

OBJECTIVE: To examined the effects of resistance training on the atherogenic index of plasma in middle-aged and older adults with type 2 diabetes mellitus. Secondary objectives included evaluating its impact on glycemic markers (hemoglobin A1c, HOMA-IR) and a broad range of cardiovascular risk factors. METHODS: We systematically reviewed and meta-analyzed 33 randomized controlled trials (n = 1396) sourced from four databases. We employed random-effects meta-analyses, along with subgroup and meta-regression analyses, to explore potential moderators of the intervention's effects. RESULTS: Resistance training led to a significant reduction in atherogenic index of plasma (effect size = -0.56), with notably stronger effects observed in overweight/obese participants. Although heterogeneity was substantial across several outcomes, its sources were partly explained by sex, body mass index, and supervision-related moderators, and findings remained consistent after exclusion of high-risk studies. Resistance training also improved glycemic control, reducing hemoglobin A1c by -0.62% and HOMA-IR by -0.90, and lowered systolic blood pressure (-3.91 mmHg) and body fat (-0.54%), while increasing VO₂max (effect size = 0.53). CONCLUSIONS: Despite heterogeneity and varying methodological quality among included trials, the pooled evidence indicates that resistance training produces clinically relevant improvements in atherogenic index of plasma and key cardiometabolic risk markers in adults with type 2 diabetes mellitus. The findings should be interpreted with caution due to differences in study design, population demographics, and geographic concentration of included studies. These results provide evidence-based insights supporting the integration of resistance training into lifestyle interventions aimed at cardiovascular risk reduction in aging populations.